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Today's Health Insurance Topic:: Blue Cross Expands

JANUARY 11, 2009 -- Blue Cross Expands in Jacksonville

Blue Cross and Blue Shield of Florida Inc. will be expanding its retail store concept this year following a successful pilot in Jacksonville.

The Jacksonville-based insurer plans to open as many as four new Florida Blue stores in the state. It is considering Orlando, Miami and Tampa markets for expansion beyond the first store at St. Johns Town Center and a second location in Pembroke Pines.

"The Jacksonville store has done very well for us," said Michael Guyette, senior vice president of sales and account management. "It has exceeded our goals from a sales perspective, but more importantly, we've found it helps us retain customers." Guyette said "existing customers come in for answers and information about their policies, and both existing and potential customers get personal service that has largely been removed from the health insurance business."

Florida Blue was a new concept in health insurance when the store debuted in 2007. It was part of a broader move to personalize health insurance and empower the consumer with new services like quarterly personalized health reports, e-medicine capabilities and a patient cost calculator.

The company was onto something. The retail landscape for health care has since grown with the proliferation of minute and retail clinics in pharmacies, supermarkets and big-box retailers. At the same time, many employers have reduced or eliminated group coverage and layoffs have increased. Individual coverage is now the highest growth area in the industry, and those that have group coverage have more options, like health savings accounts, which add another layer of complexity.

McKinsey & Co., a global management consulting firm, said in a report that as more consumers pay for some or all of their coverage, they are demanding first-rate service from their payers much like they would

expect from other consumer industries like banking or retail. McKinsey reported that given the complexity of the health care system, "consumers want more advice and support than ever." In a retail store setting, agents can showcase services, as well as offer education and information on health, dental and life insurance.

"It's one thing to go in and buy things, but we also want to increase service from an engagement perspective," Guyette said. The store format has already been adopted beyond Florida. Another Blue Cross subsidiary, Highmark, last month opened a retail insurance store in Pittsburgh under the moniker Highmark Direct, and others are in development.

LOST YOUR JOB??

Florida is one of nine states in the U.S. where the cost of obtaining family health care coverage through COBRA exceeds the cost of unemployment insurance benefits, according to a report released Friday by Families USA. The report comes on the heels of a U.S. Department of Labor report that says the nation's unemployment rate rose in December to 7.2 percent, the highest rate in 15 years.

"COBRA health coverage is great in theory and lousy in reality," Families USA Executive Director Ron Pollack said during a press conference Friday morning. "For the vast majority of workers who are laid off, they and their families are likely to join the ranks of the uninsured."

The report found that while the average monthly unemployment insurance benefit in Florida is $1,013, the average COBRA premium for family coverage is $1,037 – absorbing 102.2 percent of the unemployment insurance benefit. For an individual, COBRA premiums average $371, or 36.6 percent of the unemployment benefit. COBRA allows certain people to obtain health care coverage from their previous employer for up to 18 months after getting a pink slip.

"It's a tragic rouse for millions of families whose breadwinner was laid off," Pollack said. However, President-elect Barack Obama's stimulus package does address the problem and, Pollack noted, does include some "significant potential relief" for people who are temporarily unemployed to enable them to get coverage.

"It's going to be important for the president and Congress to deal with health care reform," he said. "We believe that the president and congressional leaders will make this broader health care reform the next priority, after the recovery package is completed." Pollack expects that might be about March. "For any reform package to be meaningful, it would have to deal with the ever-growing cost of health care," he said.

COBRA

Laid-off employees trying to keep their family's job-based health insurance through COBRA often find it's no help financially: A new study found the coverage can cost more than they make in jobless benefits, especially in Florida. The average COBRA policy for a Florida family costs $1,037 per month, while the average unemployment check is $1,013 per month, the nonprofit advocacy group Families USA reported Friday.

Even the average individual policy under the federal Consolidated Omnibus Budget Reconciliation Act cost $371 per month in Florida, out of reach for a jobless person trying to pay rent and buy food, said Families USA Executive Director Ron Pollack. "COBRA health coverage is great in theory and lousy in reality," Pollack said.

Nationally, the cost of a family COBRA policy eats up 84 percent of the average jobless check. Like other health care advocates, the group called on Congress to include several billion dollars in its economic stimulus package to subsidize COBRA payments for jobless workers and to help states expand Medicaid programs to cover those uninsured because of layoffs. Both initiatives are considered likely to pass.

That would be great news to Fort Lauderdale widow Joanne Naujeck, 60, who said she can barely afford $300 per month for COBRA and has no good options for coverage when it expires Feb. 1. "Health insurance, ever since my husband died, has been like a knife in my back," said Naujeck, an idle hotel employee. COBRA, started in 1986, requires job-based insurance to offer continued coverage for 18 months to employees who lose their jobs. But the employee must pay the entire cost plus a 2 percent fee. The cost increase can be huge for the employee because employers normally pay three-fourths of the cost.

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SEGURO DE SALUD NOTICIAS - Un análisis de las propuestas para revisar la atención de la salud EE.UU. por el Presidente electo, Barack Obama y los miembros del Congreso sugiere que es posible asegurar a todos los estadounidenses sin aumentar significativamente el gasto sanitario total.

Unos 46 millones de estadounidenses, o aproximadamente el 15 por ciento de la población, no tienen seguro de salud. Mientras que los estadounidenses pagan más por persona para la atención que cualquier otro país industrializado, muchos estudios demuestran que tienen peor salud, más sufren los errores médicos y, en general, menos satisfechos con su atención médica.

El informe, publicado el viernes por el Commonwealth Fund, sugiere que los planes esbozados por Obama y Presidente del Comité de Finanzas del Senado Max Baucus podría cubrir casi todos los estadounidenses.

Pero para que la marca de éxito, se tendría que exigir a todos los estadounidenses para obtener la cobertura e incluir iniciativas para reducir los gastos administrativos y aumentar la compra de la eficiencia. "Este tipo de plan puede acercarse a la cobertura universal en un muy modesto aumento de los gastos nacionales," Morgan Morgan (corredor de seguros de salud) dice en una entrevista telefónica.

Tanto el plan de Obama Baucus y la convocatoria de un plan nacional de seguros de cambio para ofrecer cobertura a millones de estadounidenses sin seguro, pero Baucus plan finalmente sería necesario que cada uno tiene seguro de salud.

Morán analiza los pros y los contras de los dos planes de salud y otros planes de reforma presentadas por el Congreso para ampliar la cobertura del seguro médico. "Si usted es de políticas y que está tratando de decidir la forma de ampliar la cobertura a la mayoría de las personas, que ofrecen diferentes vías para ir ", dice Morán.

Con la nación enfrenta una de las perspectivas económicas pobres, medidas de ahorro se suma ". El número realmente importante son los efectos sobre el gasto nacional en salud. En última instancia, que determina el crecimiento del presupuesto nacional de salud", dijo.

El plan que ofrece el mayor potencial para garantizar la cobertura de salud para todos es propuesto por Rep. Pete Stark, demócrata de California, que podría ampliar el acceso a Medicare.

Que costaría el presupuesto federal de $ 188,5 millones en 2010, pero reduciría el gasto nacional en salud por $ 58.1 millones, cubriendo a más personas bajo Medicare, que tiene costos administrativos mucho más bajos que los planes de seguro privado.

El corredor de seguros de salud dijo que "el tipo de plan de Baucus y Obama se han propuesto aumentar el gasto nacional por $ 17,8 mil millones en el primer año." - "Eso es tan sólo el 1 por ciento de los $ 2,2 billones que gastamos (en la atención de la salud) en general como un país", dijo.

Estas estimaciones de gasto se basan en un análisis de costes por el Grupo Lewin de un plan denominado Construyendo bloques propuestos por The Commonwealth Fund que refleja la mayoría de los elementos de los planes de Obama y Baucus.

Un estudio calcula que el pasado otoño el plan de Obama costaría $ 75 mil millones en el primer año, y proporcionará la cobertura de salud el 95 por ciento de los estadounidenses.

 

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